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Mood disorders

Characterized by unusually severe or prolonged disturbances of mood; two major forms Depressive disorders and bipolar disorders


Depressive disorders (2)

AKA unipolar disorders; include major depressive disorder and persistent depressive disorder (Dysthymia)


Major depressive disorder
-Diagnostic criteria

Episodes of severe depression; occurrence of at least one major depressive episode in absence of history of mania or hypomania. At least one of symptoms is depressed mood or loss of interest
- 12% men, 21% women, 16% overall 8%suffering now
- most common type of mood disorder
- half of depressed ppl fail to seek help; Lats and Blacks less likely to recive care than any other


mania vs. hypomania

state of unusual elation and energy vs. mild state of mania


MDD and occupational effect (3)

-Billions lost in productive work time which is greater than costs of illnesses like CVD and diabetes.
-Avg depressed worker earns 10% less
- Major depression costs avg worker 27 lost workdays (bipolar is 65)


Risk Factors in MDD

1. age of onset- common in young adults
2. SES- lower is greater risk
3. Marital status- separated at higher risk
4. Women- twice as likely; begins in adolescene persisting thru middle age


Seasonal Affect Disorder

No diagnostic category but subset; classified as MDD with seasonal pattern; Cause unknown but may be due to changes in light which alter bodies biological rhythms and regulate temperature, sleep/wake cycles. Seasonal changes might effect serotionon. Use of phottherapy.


Postpartum depression

Nearly 80% have mood changes after childbirth; 1 in 7 have PPD affecting 10-15% following one year of childbirth. Women with PPD have MDE within four weeks of delivery. In 50% of all cases depressive episodes happen before birth. Most PPD episodes don't last as long as MD.
-Diff from postpartum psychosis (losing touch with reality, hallucinations, delusions)


Persistent depressive disorder
- prevalence?
- How many go onto develop MD?

AKA Dysthymia (bad spirit); Typically begans in childhood or adolescence and follows chronic course of depression. Mild nagging symptoms lasting for years. 90% with dysth get MD; affects 4% of ppl


Double depression

Concurrent with depressive disorder and dysthymia


Premenstrual Dysphoric Disorder
-Prevalence rates

More severe form of PMS; cluster of neg physical and mood symtoms during period. Applies to women wo experience range of psych syptoms a week before period.
-Most have PMS (50%), 1 in 5 said it interfers with daily functioning, 2-5% of PDD


Bipolar disorder
- prevalence/onset/gender

Extreme mood swing between elation and depression, changes in energy. Manic episodes typically last few weeks to month and are shorter and end more abruptly than depressive episodes. Tends to be chronic. Two types depending on whether person has ever had full blown manic episode:
I- at least one full manic episode ( extreme mood swings with intervening periods of normal mood, possible for this to apply to those who have never had MDE)
II- Hypomanic episodes with history of one MDE
- some type II go onto develop I
- About 1% have either I or II; typically develops around age 20 in men and women with equal rates;


Rapid cycling

Person has two or more full cycles of mania and depression within a year without any normal periods. Occurs more often in women.


Manic episode

periods of unrealistically heightened euphoria, restlessness, excessive activity with disorganized behavior. Happens abruptly, differs from hypomania bc of severity, pressured speech, highly distractible.


Cyclothymic disorder
- How many go onto develop Bipolar?

(circle spirit) chronic pattern of less severe mood swings than bipolar, cyclical pattern of moods lasting at least two years (I for child) Begins in early adulthood and persists for years. Few periods of normal mood last longer than month.
-Most common bipolar disorder, 0.4-1% but underdiagnosed.
-1 in 3 eventually develop bipolar


Stress and depression

80% of those with MDD have source of major stress before onset. Stress assoc with interpersonal probs may contribute to those only with negative thinking.


Psychodynamic theory of depression

Freud states depression is anger directed against self; Occurs following actual or threatened loss of significant other. Mourning is normal process of psychologically separating self from person. Pathological mourning occurs in those who have ambivalent feelings (love and hate) towards person. When ppl lose this person their ambivalent feelings turn into anger/rage triggering guilt which prevents them from venting anger at lost person (object). To preserve psych connection to object they introject or bring inward a mental rep of object; anger then turned inward which leads to self-hatred/depression.


Psychodynamic view of bipolar disorder

Represent the shifting of dominance between ego and superego. In depressive phase the superego is dominant producing exaggerated notions of wrongdoing and flooding self with guilt. After time ego rebounds and asserts self-confidence that is the manic phase.


Self-focusing model

Modern psychodynamic view: considers how ppl allocate their attentional processes after a loss or personal failure. Views depressed ppl as having difficulty thinking about anything other than self or loss.


Humanistic view of depression

Depression occurs when ppl can't imbue life with meaning and make authentic choices that lead to self fulfillment. May have frustrated our needs for self actualization or be settling. Focus on loss of self-esteem that occurs when we lose loved one or suffer occupational drawbacks. We tend to connect identity and self-worth to social roles as parents ect. and when these roles change we can lose self-worth.


Learning theory of depression

Peter Lewinsohn proposed that it results from imbalance between behavior and reinforcement. Lack of reinforcement for efforts can sap motivation which leads to depression. Inactivity and social withdrawal reduce opportunities for reinforcement.
- Low rate of activity in depressed ppl may be secondary reinforcement. Family members may rally around depressed ppl and relieve them of responsibilities. (sympathy becomes source of reinforcement that maintains depression)


Interactional theory

Developed by James Coyne; adjustment to living with depressed ppl may be stressful so much that the person becomes less reinforcing. Based on reciprocal interaction- one's behavior influences how others respond to us. Depressed ppl react to stress by demanding reassurance and support which overtime elicits annoyance. These feelings surface in subtle ways.


Cognitive theories of depression

Relate origin and maintenance of depression to ways in which ppl see themselves and world
1. Cognitive triad
2. Cognitive specificity hypothesis


Cognitive triad of depression
-becks ideas

Developed by Aaron Beck; links depression to adoption early in life of a negatively biased or distorted way of thinking. Negative concepts of self and world are mental templates adopted in childhood based on learning experiences
Triad: adopting negative views of self, environment, future
Beck beliefs cognitive distortions lead to depression


Cognitive distortions assoc. with depression (10)

Developed by David Burns, distortions occur automatically
1. All or nothing thinking- b/w; perfectionism
2. Overgeneralizing- if neg event happens it will happen again
3. Mental filter- (selective abstract) focus only on neg details
4. Disqualifying the positive- denying accomplishments
5. Jumping to conclusions- forming neg interps of events despite evidence; Mind reading (others don't like you) and fortune teller error (predicting something bad happening always)
6. Magnification & Minimization- make mountains outa molehills, catastrophizing neg events and minimize pos
7. Emotional reasoning- base reasoning on emotions interp events on emotions rather than evidence
8. Should statements- self commandments of shoulds and musts; musterbation is creating unrealistic expectations
9. Labeling and Mislabeling- explain behavior by attaching neg labels to self or others
10. Personalization- assuming that one is responsible for other ppls probs


Cognitive-specificy hypothesis

By Beck; belief that diff emotional disorders are linked to diff automatic thoughts. Those with depression often report auto thoughts of loss, self-deprecation, pessimism. Those with anxiety report thoughts of physical danger or threats.


Learned helplessness model

By Martin seligman; Behavior pattern characterized by passivity and perceptions of lack of control; ppl become depressed bc they view themselves as helpless to change bc of their experiences. Depression results from exposure to uncontrollable situations which instill expectation that future outcomes are beyond control (self-fulfilling prophecy)
- Model is mix of cognitive and behavioral
- based on studies with dogs showing learned helplessness effect by failing to escape when possible.


Problems with theory of learned helplessness

Original failed to take into account low self esteem nor did it explain why some depression persists. New theory said perception of lack of control over future rewards did not itself explain persistence but need to consider cog factors.


Reformulated theory of learned helplessness

Recast theory in terms of social psychology's concept of attributional style- personal style of explanation; we explain failure or disappointment in various ways.
-Those who explain causes of neg events according to three types most vulnerable to depression:
1. Internal factors- failures reflect personal inadequacies instead of external/others
2. Stable factors- failure reflects fixed personality factors rather than unstable factors/ isolated event
3. Global factors- failures reflect sweeping flaws in personality rather than specific factors/ limited factors
All called negative attributional styles


Biological view of
-Twin studies
-genetic links

Variations in genes controlling serortonin linked to greater risk of depression in face of stress
-higher concordance rates among MZ twins providing stronger support for genetic contribution. Double concordance rate for MDD among MZ twins than DZ
- gene variations common in: MDD, bipolar, schizo, autism, ADHD